Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR FEM/POPL REVAS W/TLA

Facility

$27,397.00

Service Code	HCPCS 37224
Hospital Charge Code	321037224
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR FINE NEEDLE ASPIRATION

Facility

$2,403.20

Service Code	HCPCS 10022
Hospital Charge Code	2670010
Hospital Revenue Code	361
Min. Negotiated Rate	$57.92
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$913.22
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.82
Rate for Payer: Cigna Commercial	$1,201.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.96
Rate for Payer: Qualcare PPO/HMO/WC	$360.48
Rate for Payer: UnitedHealthcare Community & State	$57.92
Rate for Payer: Wellpoint Medicaid Managed Care	$63.68

IR FINE NEEDLE ASPIRATION

Facility

$2,403.20

Service Code	HCPCS 10022
Hospital Charge Code	2670010
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

IR FINE NEEDLE ASPIRATION

Facility

$2,403.20

Service Code	HCPCS 10022
Hospital Charge Code	7411331
Hospital Revenue Code	361
Min. Negotiated Rate	$57.92
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$913.22
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.82
Rate for Payer: Cigna Commercial	$1,201.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.96
Rate for Payer: Qualcare PPO/HMO/WC	$360.48
Rate for Payer: UnitedHealthcare Community & State	$57.92
Rate for Payer: Wellpoint Medicaid Managed Care	$63.68

IR FINE NEEDLE ASPIRATION

Facility

$2,403.20

Service Code	HCPCS 10022
Hospital Charge Code	7411331
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

IR FINE NEEDLE W/O IMAGNG GUID

Facility

$669.90

Service Code	HCPCS 10021
Hospital Charge Code	7411330
Hospital Revenue Code	361
Min. Negotiated Rate	$16.14
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.97
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.48
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$16.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

IR FINE NEEDLE W/O IMAGNG GUID

Facility

$669.90

Service Code	HCPCS 10021
Hospital Charge Code	7411330
Hospital Revenue Code	361
Min. Negotiated Rate	$100.48
Max. Negotiated Rate	$100.48
Rate for Payer: Qualcare PPO/HMO/WC	$100.48

IR FINE NEEDLE W/O IMAGNG GUID

Facility

$669.90

Service Code	HCPCS 10021
Hospital Charge Code	2670235
Hospital Revenue Code	361
Min. Negotiated Rate	$100.48
Max. Negotiated Rate	$100.48
Rate for Payer: Qualcare PPO/HMO/WC	$100.48

IR FINE NEEDLE W/O IMAGNG GUID

Facility

$669.90

Service Code	HCPCS 10021
Hospital Charge Code	2670235
Hospital Revenue Code	361
Min. Negotiated Rate	$16.14
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.97
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.48
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$16.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

IR FISTLA/SINUS TRCT ABSC STDY

Facility

$724.85

Service Code	HCPCS 76080
Hospital Charge Code	7411750
Hospital Revenue Code	320
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$2,343.27
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$454.41
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.46
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.73
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

IR FISTLA/SINUS TRCT ABSC STDY

Facility

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	2600086
Hospital Revenue Code	320
Min. Negotiated Rate	$40.66
Max. Negotiated Rate	$2,343.27
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$454.41
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

IR FISTLA/SINUS TRCT ABSC STDY

Facility

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	2600086
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR FISTLA/SINUS TRCT ABSC STDY

Facility

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	366876080
Hospital Revenue Code	320
Min. Negotiated Rate	$40.66
Max. Negotiated Rate	$2,343.27
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$454.41
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

IR FISTLA/SINUS TRCT ABSC STDY

Facility

$724.85

Service Code	HCPCS 76080
Hospital Charge Code	7411750
Hospital Revenue Code	320
Min. Negotiated Rate	$108.73
Max. Negotiated Rate	$108.73
Rate for Payer: Qualcare PPO/HMO/WC	$108.73

IR FISTLA/SINUS TRCT ABSC STDY

Facility

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	411076080
Hospital Revenue Code	320
Min. Negotiated Rate	$40.66
Max. Negotiated Rate	$2,343.27
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$454.41
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

IR FISTLA/SINUS TRCT ABSC STDY

Facility

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	411076080
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR FISTLA/SINUS TRCT ABSC STDY

Facility

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	321076080
Hospital Revenue Code	320
Min. Negotiated Rate	$40.66
Max. Negotiated Rate	$2,343.27
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$454.41
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

IR FISTLA/SINUS TRCT ABSC STDY

Facility

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	366876080
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR FISTLA/SINUS TRCT ABSC STDY

Facility

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	321076080
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR FLUOR GUID CV ACCESS DEVICE

Facility

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	7411754
Hospital Revenue Code	320
Min. Negotiated Rate	$1,303.89
Max. Negotiated Rate	$1,303.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89

IR FLUOR GUID CV ACCESS DEVICE

Facility

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	321077001
Hospital Revenue Code	320
Min. Negotiated Rate	$1,303.89
Max. Negotiated Rate	$1,303.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89

IR FLUOR GUID CV ACCESS DEVICE

Facility

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	366877001
Hospital Revenue Code	320
Min. Negotiated Rate	$1,303.89
Max. Negotiated Rate	$1,303.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89

IR FLUOR GUID CV ACCESS DEVICE

Facility

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	2004892
Hospital Revenue Code	320
Min. Negotiated Rate	$1,303.89
Max. Negotiated Rate	$1,303.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89

IR FLUOR GUID CV ACCESS DEVICE

Facility

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	2004892
Hospital Revenue Code	320
Min. Negotiated Rate	$55.45
Max. Negotiated Rate	$4,346.30
Rate for Payer: Aetna Commercial	$3,303.19
Rate for Payer: Aetna Medicare Advantage	$2,607.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,216.61
Rate for Payer: Cigna Commercial	$4,346.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,607.78
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$209.49
Rate for Payer: Wellpoint Medicaid Managed Care	$230.35

IR FLUOR GUID CV ACCESS DEVICE

Facility

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	366877001
Hospital Revenue Code	320
Min. Negotiated Rate	$55.45
Max. Negotiated Rate	$4,346.30
Rate for Payer: Aetna Commercial	$3,303.19
Rate for Payer: Aetna Medicare Advantage	$2,607.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,216.61
Rate for Payer: Cigna Commercial	$4,346.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,607.78
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$209.49
Rate for Payer: Wellpoint Medicaid Managed Care	$230.35

Know your out-of-pocket cost for care.

All Charges